Active NPI
Nilubon Methachittiphan
- Clinical Cardiac Electrophysiology Physician
- Seattle, WA
National Provider Identifier
1104112028
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Cardiac Electrophysiology Physician
- License
- MD60733931
- Practice address
- 1959 NE Pacific St Ste Bb552
Seattle, WA 98195-0553 - Phone
- (206) 685-1397
- Fax
- (206) 685-9394
- NPI assigned
- Jun 20, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 248059 | MA | |
| Cardiovascular Disease Physician | 207RC0000X | BP10049193 | TX | |
| Clinical Cardiac Electrophysiology Physician | 207RC0001X | MD60733931 | WA | Primary |
Addresses
Primary practice location
1959 NE Pacific St Ste Bb552
Seattle, WA 98195-0553
Mailing address
1959 NE Pacific St Ste Bb552
Seattle, WA 98195-0001
Phone (206) 685-1397
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 248059 | MA | MD | Internal Medicine Physician |
| BP10049193 | TX | MD | Cardiovascular Disease Physician |
| MD60733931 | WA | MD | Clinical Cardiac Electrophysiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1308528000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1104112028",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1959 NE PACIFIC ST STE BB552",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981950001",
"telephone_number": "206-685-1397",
"fax_number": "206-685-9394"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1959 NE PACIFIC ST STE BB552",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981950553",
"telephone_number": "206-685-1397",
"fax_number": "206-685-9394"
}
],
"practiceLocations": [],
"basic": {
"last_name": "METHACHITTIPHAN",
"first_name": "NILUBON",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-06-20",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MA",
"license": "248059",
"primary": false
},
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "TX",
"license": "BP10049193",
"primary": false
},
{
"code": "207RC0001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
"state": "WA",
"license": "MD60733931",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.